A Strain of Nocardia cyriacigeorgica Isolated from a Patient with Pulmonary Infection
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Nocardia cyriacigeorgica는 주로 기회 감염으로 인체 감염을 일으키는 호기성 그람양성 막대균이다. 분자생물학적 세균 동정 방법이 이용되면서부터 N. cyriacigeorgica에 의한 인체 감염의 증례들이 보고되고 있다. 환자는 재생불량빈혈, 전신 홍반루푸스, 파종결핵을 가진 51세 여자 환자로 발열, 기침, 가래를 주 증상으로 조선대학교병원에 입원하였다. 입원 중 여러 차례의 가래 배양을 시행하였고, 방선균이 의심되는 세균이 다섯 번의 배양에서 자랐다. 이 세균은 그람양성 막대 균이었고 Kinyoun 변법 염색에서 부분적인 항산성을 보였으며 lysozyme 저항성을 나타냈다. 24시간 배양 후, 혈액한천배 지에서 집락의 모양은 거칠고 윤기 없는 흰색이었으며 특유의 흙 냄새가 나는 특징적 소견을 보였다. 이상의 결과를 봤을 때 Nocardia로 추정할 수 있었다. 종 수준의 동정을 위해 16S rRNA 유전자 염기서열 분석을 시행한 결과 N. cyriacigeorgica DSM 44484T와 99.9%의 상동성을 보였다. 생화학적 검사 결과 다른 문헌들에 나온 N. cyriacigeorgica 소견에 합당하여 최종적으로 N. cyriacigeorgica로 동정되었다. 이에 저자들은 폐감염증 환자에서 분리된 N. cyriacigeorgica를 국 내 최초로 보고하는 바이다.
Abstract
Nocardia cyriacigeorgica is an aerobic gram-positive rod that has mostly been reported as an opportunistic pathogen. Since molecular methodologies were introduced to identify species, infections caused by N. cyriacigeorgica have been reported. The patient was a 51-year-old woman with aplastic anemia, systemic lupus erythematosus, and disseminated tuberculosis, who was admitted to Chosun University Hospital with a history of fever and productive cough. During her hospitalization, sputum cultures were taken and a bacterium suspicious of acitinomycetes grew five times. It was a gram-positive rod that was also partially acid-fast on modified Kinyoun stain and resistant to lysozyme. After 24 h of incubation, cultures of the sputum onto sheep’s blood agar plates (BAP) demonstrated rough, chalky, and white colonies with a characteristic earthy odor. Based on the above results, the presumptive identification of Nocardia species was made. To identify species of this isolate, 16S rRNA gene sequence analysis was taken and showed 99.9% homology to N. cyriacigeorgica DSM44484T. The results of biochemical tests were compatible with other reports of N. cyriacigeorgica. As a result, this isolate was identified as N. cyriacigeorgica. Herein, we present a first report of N. cyriacigeorgica isolated from a patient with pulmonary infection in Korea.
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